Probiotics - Why I Don’t Always Wait Until After Antibiotics
When someone is prescribed an antibiotic, the usual conversation about probiotics often begins with: "I will rebuild my gut when I am finished."
But I have never looked at our body as something we support only after it has been depleted. I would rather consider what we can do along the way than wait until the work is over, and ask our body to begin rebuilding from farther behind.
When Antibiotics Are Necessary
There are times when antibiotics are necessary and important. The point is simply that while they act against the bacteria causing an infection, they may also disturb some of the beneficial organisms living in our intestinal tract.
That is one reason diarrhea, constipation, or other changes in digestion can happen during or after a course of antibiotics.
I also value herbal and natural products that have traditionally been used to support the body's natural defences. Two of my personal favourites are Nature's SilverGuard and Olive Leaf Extract. However, these are not replacements for antibiotics when an antibiotic is medically necessary.
Why Timing May Matter
I have always believed in taking probiotics while taking antibiotics, the sooner we can begin supporting the gut, the better. I generally recommend allowing a minimum of one to two hours between the probiotic and the antibiotic.
It is nice to see research now supporting the same approach. A meta-analysis of 36 randomized trials involving more than 9,300 adults found that probiotics reduced the risk of antibiotic-associated diarrhea by 38 percent overall. The authors concluded that beginning as early as possible during antibiotic therapy appeared helpful.
Another analysis in hospitalized adults found that probiotics started within two days of the first antibiotic dose were more effective at reducing the risk of C. difficile infection than probiotics started later. The American Gastroenterological Association also offers a conditional recommendation for certain probiotic strains or combinations for people taking antibiotics to help prevent C. difficile infection.
I Also Pay Attention To The Colon
During antibiotics, many people watch for diarrhea. I also ask what is happening with bowel regularity. Many people have constipation or skip days without a bowel movement. Others fluctuate between diarrhea and constipation. Some experience digestive discomfort.
- Has the usual pattern changed?
- Is there more bloating?
- Are bowel movements slowing down?
Regular, proper elimination matters. If our digestion or bowel movements begin changing, I would rather notice early and respond appropriately than wait until the end of the prescription.
Fermented Foods And Probiotic Supplements Are Not The Same
Fermented foods can be a valuable part of a healthy diet, but, "fermented" does not automatically mean "probiotic." Some products no longer contain live microorganisms, and even when they do, the organisms and amounts may not be identified or measured in the same way they are in a well-formulated supplement. The other ingredients in the product matter too.
I also do not assume that every fermented food agrees with every person. Over the years, I have seen some clients feel more bloated, and sometimes notice their bowel movements slowing down after adding fermented foods. That does not mean fermented foods are bad. It means we still have to pay attention to how our own body responds.
I learned that lesson personally in the mid-1980s. At the time, I regularly bought miso from a health-food store. One particular batch made me very sick and affected my colon for quite some time. I cannot say that miso or fermented food itself was the cause. The batch may have been spoiled or contaminated, or something else may have happened, we simply do not know.
What it taught me was not to turn one food into either a hero or a villain, and not to ignore what our body is telling us.
Yogurt Is Not A Substitute For A Probiotic Supplement.
Yogurt can be a valuable addition to our food, but I do not consider it a substitute for a measured probiotic supplement. The organisms and amounts may not be identified in the same way, and many yogurts contain added sugar and other ingredients we may not want.
A personal preference is plain Greek yogurt because it contains more protein. I look for one with only two ingredients: milk and bacterial cultures. I simply add it to my healthy cereal and fresh fruit.
The Strain Matters And More Is Not Automatically Better
Probiotics are not one single substance. Benefits shown for one strain or combination cannot automatically be assigned to another. This is called strain specificity, and it is one reason labels, formulation, storage, and quality matter.
More strains do not automatically make a probiotic better. However, when the strains are clearly identified and thoughtfully formulated, I appreciate a broad-spectrum formula because our intestinal microbiome is itself a community.
What I Consider in Practice
A personal favourite is Probiotic Eleven. It provides 11 potent strains of friendly, rebalancing bacteria and offers powerful support for our microbiome and digestive system. In addition, its delayed-release capsules help protect probiotics from digestive acids, which is a big plus.
My bigger principle is simple: support does not begin after the burden on our body is over. Sometimes the most helpful time to think about rebuilding is while we are moving through it.